Individual provider Active NPI

Ruthven A. Wodell, MD

  • Allergy & Immunology Physician
  • Ardmore, PA
National Provider Identifier
1295780567
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
MD027612E Issued in PA
Practice address
233 E Lancaster Ave
Suite200
Ardmore, PA 19003-2321
Phone
(610) 642-1643
Fax
(610) 642-0245
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X MD027612E PA Primary

Addresses

Primary practice location

233 E Lancaster Ave
Suite200
Ardmore, PA 19003-2321

Mailing address

233 E Lancaster Ave
Suite200
Ardmore, PA 19003-2321
Phone (610) 642-1643

Other identifiers 1

IdentifierTypeStateIssuer
086078OtherPAHIGHMARK PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1295780567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 E LANCASTER AVE",
            "address_2": "SUITE200",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190032321",
            "telephone_number": "610-642-1643",
            "fax_number": "610-642-0245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 E LANCASTER AVE",
            "address_2": "SUITE200",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190032321",
            "telephone_number": "610-642-1643",
            "fax_number": "610-642-0245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WODELL",
        "first_name": "RUTHVEN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "PA",
            "license": "MD027612E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK PIN",
            "identifier": "086078",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.